Objective: The difficulty in controlling hypertension in coronary patients has been underlined. The aim of the study was to assess blood pressure profile (BP) at hospital discharge in a large population of survivors of an acute coronary syndrome.
Design and methods: An observational study was conducted in France in 77 cardiological centers. The medical records of all patients admitted in these hospitals on January 1998 for a myocardial infarction or unstable angina and who survived were studied. Clinical characteristics and BP at hospital discharge were recorded. Patients with blood pressure > or = 140/90 mmHg were considered as uncontrolled hypertensives (HT).
Results: Data were available in 1327 of the 1394 patients recruited: at hospital discharge, 344 patients (25.9%) were controlled and 431 (32.4%) were uncontrolled hypertensives. Among these patients, 406 (94.1%) had systolic blood pressure > or = 140 mmHg, 139 (32.2%) had diastolic blood pressure > or = 90 mmHg and 292 patients (67.7%) had systolic blood pressure > or = 140 mmHg and diastolic blood pressure < 90 mmHg. Pulse pressure in controlled hypertensives (51.02 +/- 10.93 mmHg) was quite similar to that in normotensives (47.81 +/- 9.84 mmHg) whereas pulse pressure was significantly higher in uncontrolled hypertensives (65.86 +/- 13.29 mmHg).
Conclusion: At hospital discharge after a coronary event, arterial hypertension is uncontrolled in 32.4% of patients mainly because of poor systolic blood pressure control. Achieving normal blood pressure throughout the hospitalisation should improve long term blood pressure control, reduce pulse pressure and improve the prognosis in this high risk population.